| NPI | 1164148094 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | VILMA BLACK Therapist/Owner 443-401-3159 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| 101YM0800X Counselor, Mental Health | |
| Enumeration Date | 2022-10-12 |
| Last Update Date | 2025-02-20 |